Tuesday, June 2, 2009

Harvard Med School, Jack Connors, and the Manipulation of Power

Sunday’s Boston Globe reported yet another conflict of interest problem in medicine. This one, however, is on a scale that will astonish even the most jaded observers of recent events.

According to two-time Pulitzer Prize winning journalist Steve Kurkjian, Jack Connors, the chairman of the board of Partners Healthcare, never bothered to inform the board that he was the major owner of a drug industry funded CME empire. The company, M/C Communications, runs the lucrative Pri-Med courses, a series of industry-funded symposia that reach 35,000 doctors per year.

According to the article, Connors bought the company (with an investment group) for $13 million in 2000, and sold it for a whopping $450 million in 2004, personally making $250 million in profit from the deal.

So what? Jack Connors is a successful businessman and entrepreneur. There’s nothing wrong with flipping a company and making a tidy sum in the process, right?

Generally speaking, that’s true. In this case, however, there was a web of undisclosed relationships that enabled Connors to make that kind of money. Connors is neither a physician nor an educator. But he knows advertising, having co-founded Hill Holiday, the main advertising firm for Partners. The way advertisers become rich is by finding rich companies and promising them a lucrative market for their products. In the world of industry-funded CME (which is merely a deceptive form of promoting industry products), that lucrative market consists of doctors. The more doctors you can attract to your courses, the more you can charge the drug companies that fund those courses. The best way to attract doctors is to promise them gold-plated medical education, and nowhere does this gold shine more brightly than at Harvard Medical School.

By being chairman of the board at Partners, Connors had access to the key decision makers at Harvard Medical School, access that would have easily allowed him to negotiate deals on behalf of his company, M/C Communications. According to the Globe article, M/C has an “exclusive commercial relationship” with Harvard Medical School. The Pri-Med website is quick to make drug companies aware of this fact:

“Because of our relationship with Harvard Medical School, clinicians are drawn to our conferences and the opportunity to engage with peers and learn about the latest advancements in the medical community.”

Did Connors actually exploit his position with Partners to hawk medicine’s equivalent of Boardwalk and Park Place to drug companies? He denies it, saying that he was only a “passive investor” and that he never spoke to Harvard’s dean about his company. Maybe he is telling the truth here...but then again, maybe not. Connors certainly damages his own credibility when he defends his decision not to disclose his ownership of M/C Communications to the Board:

“Connors said he was under no obligation to disclose his ownership of M/C Communications to the Partners board. He said that while there is an "affiliation" between Harvard Medical School and the two Partners hospitals, there is no formal contract between them.”

This is like saying that when two people marry there is not really a contract between them, only an “affiliation.”

Apparently, Connors has studied the Bill Clinton playbook of wordsmithing . Partners was literally founded in 1994 by Harvard’s two main teaching hospitals, Mass General and Brigham and Womens. There may be no “formal contract” between Partners and Harvard, but without the Partners hospitals, Harvard Medical School would have all the power, money, and prestige of a local community college.

Former Partner’s board members interviewed by Kurkjian were dismayed to learn about Connors’ odd opinion about appropriate disclosure—unfortunately, they opted to remain anonymous, perhaps fearing repercussions from Connors.

W. Micheal Hoffman, who is a specialist in corporate conflict of interest policies, explained to the Globe why this is a major PR problem for Partners:

"That's not good governance," said Hoffman, noting that M/C's relationships with Harvard Medical School and the pharmaceutical industry were close enough that Partners trustees should have discussed it. He said the board could have placed restrictions on Connors's private ventures or even demanded that he choose between his for-profit enterprises and his nonprofit chairmanship. Or, he said, after vetting the issue, the board could have decided to take no action."People are going to think that the trustees have either a laissez-faire or old-boy network attitude toward conflicts of interest," Hoffman said. "And Partners can only lose with that attitude out there."

All in all, this is a remarkable--if nauseating--example of the manipulation of power at the highest level of American medicine. Kudos to Kurkjian and the Globe for printing it. This is the kind of investigative journalism that we will lose if our newspapers go under—so keep up your subscriptions!